Abstract：Objective To explore the causes and correlated factors of the relapse of bipolar disorder, and to provide basis for early treating of bipolar disorder and preventing of relapse. Methods With case-control study method, 96 confirmed cases with bipolar disorder were divided into case group and control group according to relapse, and we collected possible correlated factors of the relapse of bipolar disorder through following-up. Then, single factor and multiple factors analysis methods were used to screen influencing factors of bipolar disorder. Results The incidence rate of relapse of bipolar disorder in 2 years was 51.0% (49/96). Multiple factors analysis result showed that the protective factors of the relapse of bipolar disorder included use of mood stabilizer (OR=0.157), use of antipsychotics (OR=0.258) and long-term use of stabilizer (OR=0.207), while the risk factors of the relapse of bipolar disorder contained long-term use of benzodiazepine (OR=3.931), somnipathy (OR=7.001) and delayed first treatment (OR=3.607). Conclusion There is a high relapse rate of bipolar disorder, and it is intimately correlated with rationality and sufficiency of medication, substance abuse, somnipathy, delayed first treatment, somatic disease and life events.
[1] 杜义敏,程月红,王学义.双相障碍复发风险因素分析[J].河北医药,2013,35(23):3608-3609. [2] 沈渔邨.心境障碍精神病学[M].5 版,北京:人民卫生出版社,2009:544-591. [3] 杜义敏,程月红.双相情感障碍复发风险因素的研究进展[J].河北医药,2015,37(2):256-258. [4] Paholpak S, Jaikasemwong S, Roumcharoenkiat A, et al. Clinical outcome of valproate maintenance treatment in bipolar I disorder at Srinagarind Hospital[J]. J Med Assoc Thai, 2014,97(4):431-438. [5] Suppes T, Vieta E, Gustafsson U, et al. Maintenance treatment with quetiapine when combined with either lithium or divalproex in bipolar I disorder: analysis of two large randomized,placebo-controlled trials[J]. DepressAnxiety, 2013,30(11):1089-1098. [6] 赵杰,刘铁榜.双相障碍病耻感综述[J].中国心理卫生杂志,2015,29(6):442-445. [7] 姜涛,汤宜朗,蔡焯基.心境稳定剂临床应用的研究进展[J].临床精神医学杂志,2003,13(1):175. [8] Perlis RH, Ostacher MJ, Miklouitz DJ, et al. Benzodiazepine use and risk of recurrence in bipolar disorder: a STEP-BD report[J]. J Clin psychiatry, 2010,71(2):194-200. [9] Goossens PJ, Kupka RW, Beenties TA, et al. Recognising prodromes of manic or depressive recurrence in outpatients with bipolar disorder: across-sectional study[J]. Int J Nurs Stud, 2010,47(10):1201-1207. [10]Kessing LV. The effect of comorbid alcoholism on recurrence in affective disorder a case register study[J]. J Affect Disord, 1999,53(2):49-55. [11]Post RM, Leverich GS, Kupka RW, et al. Early-onset bipolar disorder and treatment delay are risk factors for poor outcome in adulthood[J]. J Clin Psychiatry,2010,71(7):864-872. [12]张海燕,温盛霖,康庄,等.双相障碍Ⅱ型患者的认知功能及其影响因素[J].中华临床医师杂志,2013,7(15):6918-6921.
